@layout("/common/_form.html",{js:["/assets/modular/system/gcgWsjdYinhangka/gcgWsjdYinhangka_add.js"],css:["/assets/expand/module/formSelects/formSelects-v4.css"]}){

<form class="layui-form" id="gcgWsjdYinhangkaForm" lay-filter="gcgWsjdYinhangkaForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="gcgWsjdYinhangkaId" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">姓名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="khMing" name="khMing" placeholder="请输入姓名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">银行<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="khHang" name="khHang" placeholder="请输入银行" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">卡号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="khZhanghao" name="khZhanghao" placeholder="请输入卡号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">身份证<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="khSfz" name="khSfz" placeholder="请输入身份证" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">电话<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="khTel" name="khTel" placeholder="请输入电话" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">财务姓名</label>
                        <div class="layui-input-block">
                            <input id="cwName" name="cwName" placeholder="请输入财务姓名" type="text" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">财务电话</label>
                        <div class="layui-input-block">
                            <input id="cwTel" name="cwTel" placeholder="请输入财务电话" type="text" class="layui-input"/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">描述</label>
                        <div class="layui-input-block">
                            <input id="remark" name="remark" placeholder="请输入描述" type="text" class="layui-input"/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" id="cancel">&emsp;取消&emsp;</button>
    </div>

</form>

@}